Department of Neurology, Cardinal Tien Hospital, Fu Jen Catholic University, New Taipei City, Taiwan.
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Sci Rep. 2021 May 6;11(1):9700. doi: 10.1038/s41598-021-89228-x.
Chinese have a higher stroke incidence and a different distribution of ischemic stroke (IS) subtypes as compared with Caucasians. Herein we aimed to investigate the prevalence and associations of major risk factors in IS and its subtypes in Chinese patients. From 2006 to 2011, we included 4953 acute IS patients consecutively recruited in National Taiwan University Hospital Stroke Registry (mean age 68 years; male 59%). For each risk factor, we accessed the proportion in all IS patients, and calculated odds ratios for each main IS subtype versus other subtypes. Multiple logistic regression models were used to adjust for confounders, and to examine the associations of risk factors with IS subtypes. Compared with other ischemic subtypes, large artery atherosclerotic and lacunar strokes were associated with hypertension, diabetes, and hyperlipidaemia, while cardioembolic strokes were associated with ischemic heart disease. Furthermore, the associations with hypertension and diabetes became stronger in lacunar strokes after adjusting for confounders, but not in other ischemic subtypes. Here we report the variable effects of risk factors on different IS subtypes in Chinese patients in Taiwan. Our findings could help shed light on different mechanisms of IS subtypes and provide targets to make more effective strategies for IS prevention.
与白种人相比，中国人的中风发病率更高，且缺血性中风（IS）的亚型分布也不同。本研究旨在探讨中国 IS 患者主要危险因素的流行情况及其与 IS 亚型的相关性。2006 年至 2011 年，我们连续纳入了台湾大学医院中风登记处的 4953 名急性 IS 患者（平均年龄 68 岁；男性 59%）。对于每个危险因素，我们评估了所有 IS 患者中的比例，并计算了每种主要 IS 亚型与其他亚型的比值比。采用多因素逻辑回归模型调整混杂因素，并检验危险因素与 IS 亚型的相关性。与其他缺血性亚型相比，大动脉粥样硬化性和腔隙性中风与高血压、糖尿病和高脂血症有关，而心源性栓塞性中风与缺血性心脏病有关。此外，在调整混杂因素后，腔隙性中风与高血压和糖尿病的相关性增强，但在其他缺血性亚型中则没有。本研究报告了台湾汉族患者不同 IS 亚型中危险因素的可变作用。我们的发现可以帮助揭示 IS 亚型的不同机制，并为制定更有效的 IS 预防策略提供目标。
